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Induction

Propofol

Alkylphenol · Diprivan

Mechanism: GABA-A receptor agonist; potentiates chloride conductance.

Calculate dose for your patient

Enter weight (kg or lb). Always verify before administration.

Computed weight
70.0 kg · 154.3 lb
Induction
105 mg – 175 mg
= 10.50–17.50 mL (10 mg/mL)
↓ 25–50% in elderly, hypovolemic, frail.
Maintenance infusion
7000 mcg – 14000 mcg
= 0.70–1.40 mL (10 mg/mL)
mcg/kg/MIN. Sedation 25–75 mcg/kg/min.

Weight is saved on this device for the next calculator you open.

Full dose calculator
Onset
~30 seconds
Duration
5–10 min (single bolus)
Metabolism
Hepatic (glucuronidation); extrahepatic clearance present.

Dosing

Adult
Induction: 1.5–2.5 mg/kg IV. Maintenance: 100–200 mcg/kg/min. Sedation: 25–75 mcg/kg/min.
Pediatric
Induction: 2.5–3.5 mg/kg IV (higher than adults).

Indications

  • Induction & maintenance of GA
  • ICU sedation
  • Procedural sedation

Contraindications

  • Egg/soy allergy (relative)
  • Severe hemodynamic instability

Side Effects

  • Hypotension (dose-dependent)
  • Apnea
  • Pain on injection
  • Hypertriglyceridemia (prolonged infusion)
  • Propofol infusion syndrome (PRIS) — rare, with infusions >4 mg/kg/h >48 h

Clinical Pearls

1Reduce dose 25–50% in elderly / hypovolemic / sick patients.
2Add 20–40 mg lidocaine to syringe to reduce injection pain.
3Antiemetic at sub-hypnotic doses (10–20 mg).

References & Further Reading

  1. 1
    Textbook

    Flood P, Rathmell JP, Shafer S. Stoelting's Pharmacology and Physiology in Anesthetic Practice. 5th ed. Philadelphia: Wolters Kluwer; 2015.

  2. 2
    Textbook

    Gropper MA, Miller RD, Cohen NH, et al., eds. Miller's Anesthesia. 9th ed. Philadelphia: Elsevier; 2020.

  3. 3
    Textbook

    Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC, Ortega R, Sharar SR, Holt NF. Clinical Anesthesia. 8th ed. Philadelphia: Wolters Kluwer; 2017.

  4. 4
    Textbook

    Adriano A, Morris R, eds. 2021 CA-1 Tutorial Textbook (15th Ed.). Stanford University Medical Center, Department of Anesthesiology.

Citations are provided to direct further study. Always check the most current edition of guidelines and society recommendations — the information in this chapter is a teaching summary, not primary source material.